The majority of cancer presents as a complex phenotype and is manifest through gene-gene, and/or gene-environment interactions. An ideal paradigm for the investigation of complex cancer phenotypes in humans is primary hepatocellular carcinoma (HCC). Molecular studies of genetic alterations in tumors have identified p53 as a tumor suppressor gene commonly altered in HCC. Epidemiologic studies have firmly established the role of chronic hepatitis B virus infection (HBV) and aflatoxin B1 (AFB1) exposure as environmental risk factors. However, the majority of individuals exposed to HBV and AFB1 do not develop HCC. Genetic analysis is being used to assess the role of genes in well-described pathways in determining disease. This approach merges gene mapping and candidate locus studies by including as candidates all the members of a pathway. Each gene of interest is "tagged" with multiple polymorphic sites, in or near it, to identify genetic factors modulating the risk of developing HCC among populations exposed to AFB1. The individual members of each family (GSTA1, GSTM1, GSTM3, GSTP, GSTT1, GST12, EPHX1, EPHX2, GSTA4, GSTT2, GSTZ1, STP, COMT, ESD, DTD, CYP, MGST1) have been tagged with new or published polymorphisms, and their role in HCC risk examined, in a nested case-control population. The loci GSTM1, GSTP, GSTT1, EPHX1 showed significant association with HCC risk while the EPHX2 locus was associated with age of onset. When results were stratified by the HBV status of the case, GSTM1 and GSTT1 were associated only in the HBV(+) cases, while GSTP was associated in the HBV(-) cases. These results indicate that these genes are candidates for more detailed functional and genetic analysis. Candidate gene variation at the 15 candidate cancer susceptibility loci will also be examined in a large case-control study (n=1000 cases and 1000 controls). Genetic information important in complex trait analysis may be accessible from the joint study of heritable variation and somatic tissue (tumor) variation in cancer. HCC tumor/normal pairs were examined using a collection of genome-wide simple tandem repeat polymorphism (STRP) markers, candidate loci, and the 1,300 single nucleotide polymorphisms (SNPs) present on the Affymetrix HuSNP chip. This data is being analyzed to identify regions of loss of heterozygosity (LOH). A preliminary analysis indicating regions of LOH on chromosomes 3,4,8,9,16 and 17 is being correlated with gene expression data collected from the same samples using Affymetrix HG-U95A chips containing ~12,000 characterized genes. The study will be expanded to include expression data using the Affymetrix HG-U133 chips (~ 45,000 probe sets) and SNP data for refining the regions of LOH using the Affymetrix Mapping 10K Array (~10,000 SNPS). In addition, the larger case-case control study mentioned above will be utilized in this expanded analysis. Data collected on gene expression, candidate loci, and somatic allele loss will be integrated via hierarchical clustering of expression data, and correlation of the resulting clusters with variation at candidate susceptibility loci. This information will be used to develop, test, and validate laboratory strategies for pathway models of the cancer/normal cell.